For a long time, our traditional publicity and education on diabetes is that diabetic patients absolutely can not eat sugar, nor can they eat any sweet food or dishes with sugar, so that the majority of diabetic patients, sugary drinks can not drink, sweet dishes food can not eat, to participate in social activities, friends and family gatherings are subject to many restrictions. Some people are afraid of sugar and have a great fear of sugar. They are under great mental pressure to eat and drink anything, and lose the joy of life. I met an elderly patient who, despite being paralyzed in bed, wanted to eat white sugar every day and cursed when he was not given it, so I really couldn’t help him.
I often encounter diabetic patients asking me questions like, “Doctor, please tell me what food I can eat? What foods can I not eat?” It seems that if he avoids the so-called forbidden foods for diabetic patients, his blood sugar will be well controlled. Whenever I encountered such a situation, I would tell the patient, “You can eat almost anything as long as your total calorie intake is well controlled. The diabetic diet is the healthiest diet, and not only should diabetics eat this way, but every normal person should eat this way too.” Many patients are always half-heartedly hoping to find a shortcut to controlling their blood sugar.
As we all know, for diabetic patients, how to scientifically choose and reasonably match the diet is one of the most basic and important treatment methods for diabetes, not only is it an important treatment measure to ensure that blood sugar reaches the standard and prevent serious complications of heart, brain, eye and kidney blood vessels, but also an indispensable and necessary means to enjoy the food culture, add fun to life and improve the quality of life. In the past, we have been using the food exchange method to guide diabetic patients how to choose food, many doctors and diabetic patients have some knowledge of this again, this classic method had played an important role in sugar control, however, only pay attention to chemically equivalent carbohydrates and energy, without considering the different types of equivalent carbohydrates and other food components on blood sugar, especially the exchange table does not reflect the In particular, the exchange tables do not reflect the differences in glycemic response of different foods. In addition, the dietary restrictions for diabetic patients are too harsh, and there are even some misconceptions that make diabetic patients’ diet boring, monotonous, lack of nutrition, lower immune function, and lower quality of life.
In fact, do not look at the diabetic diet treatment how difficult, from the point of view of nutrition, as long as you know the scientific collocation and food production nutrition principle, sometimes “lazy” a little easier to reduce the blood sugar production of food – for example, coarse food not fine work, vegetables do not cut For example, don’t cut up coarse grains, don’t cut up vegetables, don’t grind up beans …… These “tips” on eating habits can greatly reduce the body’s ability to lower blood sugar production. In fact, they all involve a concept newly introduced in the field of diabetic diet therapy: the “food glycemic index”.
GI refers to the ability of a food to cause a rise in blood glucose in humans, a classification that uses the ability of carbohydrates to raise blood glucose, and is a valid physiological parameter for evaluating the response of food to postprandial blood glucose by comparing the effect of the same weight of carbohydrates in food on blood glucose.
Foreign epidemiological studies have shown that a group that consumes low GI foods as their main diet has significant health implications for the prevention of diabetes, hypertension and obesity. Low GI diets can improve blood glucose, lower plasma total cholesterol, triglycerides and LDL, and increase HDL in diabetic patients, which can reduce the risk of diabetes and cardiovascular disease, and have not only short-term effects but also long-term health significance.
High GI food, after entering the gastrointestinal tract, is quickly digested and absorbed, glucose is released quickly, and the peak of glucose entering the bloodstream is high, which means that the degree of blood glucose elevation is greater;
Low GI foods have long residence time in the stomach and intestines, low absorption rate, slow release of glucose, and low peak and slow decline of glucose into the blood, which simply means that the degree of blood glucose elevation is lower.
Therefore, the application of GI and reasonable arrangement of meals are of great benefit to the regulation and control of human blood sugar. Generally speaking as long as half of the food is replaced from high GI to low GI, significant improvement of blood sugar can be obtained.
When the GI is below 55, the food is a low GI food;
When the GI is between 55 and 70, the food is a medium GI food;
When the GI is above 70, the food is a high GI food.
However, the GI value of any food is not fixed and is influenced by many factors, including
1. ripeness. For example, the riper the banana, the higher its GI value. This applies especially to those fruits that continue to ripen after harvest.
2. The acidity of the food. When food contains acid, it reduces the rate at which the body can digest this food. A lower digestion rate means slower absorption and a more beneficial effect on blood sugar.
3, individual differences in the speed of carbohydrate digestion. Tests on five subjects will show that they react differently to the same food. The GI value should be used as a guide while monitoring the effects of carbohydrate foods on you, especially if you have diabetes.
4. The type of flour (if any) in the product. The more refined white flour in the product, the higher the GI value; the more coarse grain flour, the lower the GI value.
5. Cooking time. The cooking process expands the starch molecules, thus softening the food (the longer the cooking time, the fluffier the food), making the food easier to digest and faster to absorb. the GI value usually increases with longer cooking time.
6, other ingredients. If high GI value food and food containing protein or fat are consumed at the same time, the GI effect of carbohydrates will be lower than when consumed alone, because fat and protein will slow down their digestion. Similarly, the GI value of low GI foods will increase if carbohydrates are added.
When we know the above knowledge of GI, many people can think of a question, then those high GI food we must not eat? For example, watermelon has a GI value of 72, which can be classified as a high GI value. But we know that watermelon is a healthy food. And there are studies that prove that moderate consumption of watermelon will not cause a significant increase in blood sugar. This shows that a high GI does not necessarily cause an increase in blood sugar, but also depends on the amount of sugar in the food. For this reason, in 1997, researchers from Harvard University Salmeron et al. proposed the “glycemic load (GL)”.
The new concept of “glycemic load (GL)” was introduced by Salmeron et al. in 1997 to make it easier and more intuitive for diabetics to choose and match their diets appropriately.
GL combines the quantity and quality of carbohydrates, and represents the magnitude of the effect of a certain quality (weight) of food on human blood glucose, which is calculated as follows: the weight of the actual available carbohydrates in the food consumed is multiplied by the GI value of the food, and then divided by 100. GL can quantify the glycemic effect of the actual food provided or the overall dietary pattern, so GL is more comprehensive than GI. GL in combination with the GI value reflects the amount of available carbohydrate contained in a typical serving of a given food and is therefore closer to the actual diet.
A high GL is when the GL is greater than or equal to 20, suggesting that the corresponding weight of food consumed has a significant effect on blood glucose.
When the GL is between 10 and 20, it is a medium GL, suggesting that the corresponding weight of food consumed has an average effect on blood glucose.
When the GL is less than or equal to 10, it is low GL, suggesting that the corresponding weight of food consumed has little effect on blood sugar.
Now we still take watermelon as an example above. We know that watermelon has a high GI value, now calculate its GL and see how it is.
If we want to eat a piece of 3 taels of watermelon, check the food composition table to know that the carbohydrate content of watermelon is 5.5 grams in 100 (2 taels), the available carbohydrates contained in 3 taels of watermelon is 5.5*150/100=8.25, the GI value is 72. The GL value of watermelon is calculated as follows: 8.25*72/100=5.94, which is about 6. In this way, we know The effect of eating 3 taels of watermelon at a time on blood sugar is not much, is it?
Similarly, if we want to eat a piece of 1 pound of watermelon, we can check the food composition table to know that the carbohydrate content of watermelon is 5.5 grams in 100 (2 taels), and the available carbohydrate in 1 pound of watermelon is 5.5*500/100=27.5, with a GI value of 72. The GL value of watermelon is calculated as follows: 27.5*72/100=19.8, which is about 20. The effect of eating 1 pound of watermelon at a time on blood sugar is more obvious.
In addition, the glycemic index of soda crackers is also 72, but it contains about 76 grams of carbohydrates per 100 grams, and the available carbohydrates contained in 3 taels (150 grams) are 76/100*150=114, the GL of these 3 taels of soda crackers = 72*114/100=82.08, which has a great impact on blood sugar;
And when we consume 20 grams of soda crackers, its GL=72*76/100*20/100=10.944, which has little effect on blood sugar.
So by applying the GL we will know that it is OK to include high GI foods in the diet plan. In other words, for any food, diabetic patients are allowed to eat, only the weight of the food should be strictly controlled. Remember, by refusing to eat certain foods – especially high GI fruits, vegetables, coarse grains and legumes – you may be missing out on a significant amount of vitamins, minerals and fiber.
Therefore, when choosing foods and matching dietary structures, diabetics should follow the concept of combining GI and GL to choose and match meals, taking into account both the quality of the carbohydrates contained in the food, i.e., the rate of digestion and absorption; and the total amount of carbohydrates contained in the food and its effect on glycemic load. A comprehensive balance of quality and quantity of carbohydrates is undoubtedly the most scientifically sound, diversified and humane combination of diabetic diet. Currently, the classic food exchange method of total calorie control is the most commonly used in diabetic diet control and education. This method is simple and easy to use and can be easily operated by patients in their daily life. Total calories and total sugars are calculated according to the individual’s needs and can be interchanged in different recipe groups. However, the main drawback of this method is that it does not correctly represent the differences in blood glucose and insulin response caused by each food after a meal; it also fails to consider the effects of different food processing and cooking methods on blood glucose and insulin. Incorporating the concepts of GI and GL into the health education of diabetic diet, linking them with the food exchange method, and widely publicizing them to help patients scientifically choose foods with low GI and GL is conducive to reducing the load on pancreatic islet cells, which is of great clinical significance to effectively control and stabilize blood glucose, reduce cardiovascular and cerebrovascular complications of diabetes, and improve the quality of life of patients.